Provider Demographics
NPI:1548703556
Name:BLA PARTNERS, LLC
Entity type:Organization
Organization Name:BLA PARTNERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHERIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILIP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-391-0476
Mailing Address - Street 1:530 COMMUNITY DR.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6834
Mailing Address - Country:US
Mailing Address - Phone:802-863-4105
Mailing Address - Fax:802-448-3196
Practice Address - Street 1:530 COMMUNITY DR
Practice Address - Street 2:SUITE 2
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6834
Practice Address - Country:US
Practice Address - Phone:802-863-4105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory